INSTITUTE OF PUBLIC HEALTH COLLEGE OF MEDICINE AND HEALTH SCIENCE UNIVERSITY OF GONDAR Influence of mass media exposure on family planning in Ethiopia: EDHS analytical study Investigator: Asmamaw Ketemaw (BSc) Advisors: Dr. Desalegn Tegabu (MD, MPH, MA) Mr. Tesfahun Melesse (BSC, MPH) A THESIS SUBMITTED TO THE INSTITUTEOF PUBLIC HEALTH, COLLEGE OF MEDICINE AND HEATLH SCIENCES, UNIVERSITY OF GONDAR IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTTER OF PUBLIC HEALTH IN HEALTH INFORMATICS June 2014 Gondar, Ethiopia University of Gondar College of Medicine and Health Sciences Institute of Public Health Impact of mass media exposure on family planning in Ethiopia: EDHS analytical study By: Asmamaw Ketemaw (BSc) Contact Addresses: Phone number: 0936311611 E-mail: [email protected] Approved by the Examining board ------------------------------------- ----------------------------------------------------- Head, Institute of public health ____________________________ ---------------------------------------------------- Advisors Name Signature 1. Desalegn Tegabu (MD , MPH, MA). ---------------------- 2. Mr. Tesfahun Melesse (BSC, MPH) _____________ Examiner Signature 1. ________________________ ______________________ 2. ----------------------------------------- -------------------------------------- ACKNOWLEDGMENT I would like to express my gratitude to Dr. Desalegn Tegabu (MD, MPH, MA) and Mr. Tesfahun Melese (BSC, MPH) for their support during my thesis preparation. I also want to extend my acknowledgment to University of Gondar health informatics department for their support and Amhara regional Health Bureau for giving me this opportunity. ii TABLE OF CONTENTS ACKNOWLEDGMENT .................................................................................................................................... ii List of figures ................................................................................................................................................ vi List of tables ................................................................................................................................................ vii LIST OF ACRONYMS ................................................................................................................................... viii ABSTRACT .................................................................................................................................................... ix 1. INTRODUCTION ..................................................................................................................................... 1 1.1. Statement of the problem ............................................................................................................ 1 1.2. Literature review ........................................................................................................................... 2 1.2.1. Mass media in Ethiopia ............................................................................................................. 3 1.2.2. History and progress of family planning in Ethiopia ................................................................. 4 1.2.3. Mass media and health ............................................................................................................. 5 1.2.4. Mass media and family planning .......................................................................................... 6 1.2.5. Family planning utilization .................................................................................................... 8 1.2.6. Trends of family planning...................................................................................................... 9 1.2.7. Conceptual framework ....................................................................................................... 10 1.3. Justification of the study ............................................................................................................. 11 2. OBJECTIVE............................................................................................................................................ 12 2.1. General objective ........................................................................................................................ 12 2.2. Specific objective ........................................................................................................................ 12 3. METHODS AND MATERIALS ................................................................................................................ 13 3.1. Study design ................................................................................................................................ 13 3.2. Study area ................................................................................................................................... 14 3.3. Source population ....................................................................................................................... 14 3.4. Study population ......................................................................................................................... 14 iii 3.4.1. Inclusion criteria .................................................................................................................. 14 3.4.2. Exclusion criteria: ................................................................................................................ 14 3.5. Sample Size and sampling procedure ......................................................................................... 15 3.6. Study variables ............................................................................................................................ 17 3.6.1. Outcome/ dependent variable ........................................................................................... 17 3.6.2. Explanatory/ Independent variables ................................................................................... 17 3.7. Operational definitions ............................................................................................................... 18 3.8. Data collection ............................................................................................................................ 19 3.9. Data management and analysis .................................................................................................. 20 4. ETHICAL CONSIDERATION ................................................................................................................... 21 5. RESULT ................................................................................................................................................. 22 5.1. Characteristics of respondents ................................................................................................... 22 5.2. Mass media exposure ................................................................................................................. 26 5.3. Exposure to family planning messages ....................................................................................... 30 5.4. Mass media and family planning ................................................................................................ 32 5.5. Trends of mass media and family planning ................................................................................ 34 6. DISCUSSION ......................................................................................................................................... 36 7. STRENGTH AND LIMITATION OF THE STUDY ..................................................................................... 39 7.1. Strength....................................................................................................................................... 39 7.2. Limitation .................................................................................................................................... 39 8. CONCLUSION AND RECOMMENDATION ............................................................................................ 40 9. REFERENCE .......................................................................................................................................... 41 10. ANNEXES ......................................................................................................................................... 44 Annex one: explanatory variables ........................................................................................................... 44 Annex two: Dummy tables ...................................................................................................................... 46 iv Annex: three ............................................................................................................................................ 51 DECLARATION .......................................................................................................................................... 53 ASSURANCE OF INVESTIGATOR ............................................................................................................... 54 v List of figures Figure 1. Conceptual framework which shows the relationship of mass media with family planning in Ethiopia from EDHS data sets. ................................................................... 10 Figure 2. Diagrammatic representation showing the sampling technique for this study from surveyed women in the age of 15-49 from the three EDHS(2000,